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RCT for Feeding after Pyloromyotomy
Timestops (5)
00:00:03
Publication details: Journal and year.
00:00:08
Introduction of the RCT performed at Riley Hospital.
00:00:18
Comparison of relaxed vs
Comparison of relaxed vs. standard incremental feeding strategies.
00:00:30
Key finding
Key finding: Relaxed feeding decreased time to goal feeds and length of stay.
00:00:41
Impact of low serum chloride on reaching feeding goals.
Tools Used
Topic Overview
Randomized trial comparing ad libitum versus incremental feeding protocols after pyloromyotomy for pyloric stenosis. Relaxed feeding strategy reduced time to goal feeds and length of stay without increasing vomiting or readmissions. Preoperative hypochloremia predicted delayed feeding tolerance.
Key Takeaways
- Relaxed ad lib feeding after pyloromyotomy reduces time to goal feeds and hospital length of stay versus incremental scheduled protocols.
- No significant difference in post-operative vomiting or readmission rates between relaxed and standard feeding approaches.
- Patients with admission serum chloride <100 take significantly longer to reach feeding goals regardless of protocol used.
- Traditional incremental Pedialyte feeding schedules may be unnecessarily conservative for most pyloric stenosis patients.
- Early aggressive feeding is safe and effective post-pyloromyotomy when metabolic derangements are corrected.
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Transcript
Here is an article you should know about. It was published in the Journal of Pediatric Surgery in 2016. Dr. Markel and his team at the Riley Hospital for Children, performed a randomized controlled trial to assess feeding after surgery for pyloric stenosis. They compared a relaxed feeding strategy that was mostly ad lib, to their standard incremental feeding protocol of scheduled Pedialyte half and full strength feeds. They found that a relaxed feeding strategy decreased the time to goal feeds and overall length of stay, without significant differences in post-operative vomiting or readmissions. Those with serum chloride less than 100 on admission, took significantly longer to reach their feeding goal. Check out the link below.
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